Pulmonary Fibrosis: High Resolution CT Diagnosis

Ganesh Raghu, M.D.,FCCP, FACP Professor of Medicine & Lab Medicine (Adjunct) Division of Pulmonary & Critical Care Medicine University of Washington(UW) Director,CENTER for Interstitial Lung Disease(ILD),UW Medicine, ILD, Sarcoid and Pulmonary Fibrosis Program Co-Director, Scleroderma Clinic, UW Medical center(UWMC) Seattle, WA 98195MedicalResearch.com Interview with:
Ganesh Raghu, M.D.,FCCP, FACP
Professor of Medicine & Lab Medicine (Adjunct)
Division of Pulmonary & Critical Care Medicine
University of Washington(UW)
Director,CENTER for Interstitial Lung Disease (ILD),UW Medicine,
ILD, Sarcoid and Pulmonary Fibrosis Program
Co-Director, Scleroderma Clinic, UW Medical center(UWMC)
Seattle, WA 98195

MedicalResearch.com: What are the main findings of the study?

Dr. Raghu: In a subgroup of patients with typical clinical features of Idiopathic pulmonary fibrosis ( IPF) , further evaluation by a thorough evlauation by regional experts experienced in management of idiopathic pulmonary fibrosis and related diseases may lead to a diagnosis of idiopathic pulmonary fibrosis without the need for surgical lung biopsy if the HRCT features have a Possible-UIP pattern AND if there are no suspicion for environmental factors or collagen vascular diseases to explain the pulmonary fibrosis .

MedicalResearch.com: Were any of the findings unexpected?
Dr. Raghu:

  • The HRCT pattern of Inconsistent- UIP does not exclude UIP in surgical lung biopsy

MedicalResearch.com: What should clinicians and patients take away from your report?
Dr. Raghu:

  • General clinicians and confronted patients must familiarise themselves with clinical manifestations of Interstitial lung diseases , Idiopathic interstitial pneumonias and Idiopathic pulmonary fibrosis( IPF )
  • These findings MUST not be extrapolated to the interpretation of HRCT pattern of possible UIP by general /community physicians and general radiologists
  • Prompt referral to regional experts, experienced with management of ILD for an accurate diagnosis.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Dr. Raghu: Ascertain sensitivity and specificity of the possible-UIP pattern in consecutive patients evalutated for ILD / idiopathic interstitial pneumonia

Citation:

Diagnosis of idiopathic pulmonary fibrosis with high-resolution CT in patients with little or no radiological  evidence of honeycombing: secondary analysis of a randomised, controlled trial

Ganesh Raghu, David Lynch, J David Godwin, Richard Webb, Thomas V Colby, Kevin O Leslie, Juergen Behr, Kevin K Brown, James J Egan,

Kevin R Flaherty, Fernando J Martinez, Athol U Wells, Lixin Shao, Huafeng Zhou, Patricia S Pedersen, Rohit Sood, A Bruce Montgomery, Thomas G O’Riordan

www.thelancet.com/respiratory

Published online February 18, 2014 http://dx.doi.org/10.1016/S2213-2600(14)70011-61